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Diagnosis and Treatment of Primary Central Nervous System Angiitis
We present a contemporary literature review that should update physicians who encounter this patient population.Recent findingsRecent additions to the literature in form of case reports and single-center series show that digital subtraction angiography was the most widely used test to diagnose PCNSA. It is also important to note that brain biopsy is still considered “gold standard” and should be pursued as it not only has information that establishes the diagnosis but also may help in ruling out the diagnosis from mimics. In around 39% of suspected cases, an alternate diagnosis was eventually confirmed highlighting the...
Source: Current Treatment Options in Neurology - August 4, 2018 Category: Neurology Source Type: research

Novel Therapeutic Options in Treatment of Idiopathic Inflammatory Myopathies
AbstractPurpose of reviewThe purpose of this review is to update the audience on the recent progress in the treatment of idiopathic inflammatory myopathies, highlighting a myriad of treatment trials aimed at slowing down progression of muscle weakness and/or skin involvement in idiopathic inflammatory myopathies.Recent findingsMyositis continues to be an active area of clinical and translational research. Through the work of a number of investigators, we now have a much better understanding of the pathogenesis underlying the various myositides. The role of T cells, B cells, and dendritic cells has been better defined in de...
Source: Current Treatment Options in Neurology - July 23, 2018 Category: Neurology Source Type: research

Orthostatic Tremor: Pathophysiology Guiding Treatment
AbstractPurpose of reviewOrthostatic tremor (OT) is a rare disorder characterized by tremor and a feeling of unsteadiness while standing that resolve upon walking or sitting. A pathognomonic 13 –18 Hz tremor is seen on surface EMG while standing. Though its clinical features have been better defined over time, much of its pathophysiology remains unknown and treatment options are limited. We review here recent developments in both of these areas.Recent findingsSeveral recent studies have furthered our understanding of the central oscillatory network involved in OT. fMRI and18F-FDG-PET studies have identified a ponto-cere...
Source: Current Treatment Options in Neurology - July 21, 2018 Category: Neurology Source Type: research

Congenital Myasthenic Syndromes: a Clinical and Treatment Approach
AbstractPurpose of reviewCongenital myasthenia syndromes are clinically and genetically heterogeneous but treatable conditions. Careful selection of drug therapy is paramount as the same drug can be effective, ineffective, and even harmful in different congenital myasthenia syndromes. The purpose of this article is to review current treatment options for these conditions.Recent findingsNext-generation sequencing has accelerated the discovery of new genes and facilitated the description of novel congenital myasthenic syndromes. Retrospective therapy data from these newly identified syndromes has provided additional insight ...
Source: Current Treatment Options in Neurology - July 21, 2018 Category: Neurology Source Type: research

Management of Subdural Hematomas: Part II. Surgical Management of Subdural Hematomas
AbstractPurpose of reviewManagement of patients with subdural hematomas starts with Emergency Neurological Life Support guidelines. Patients with acute or chronic subdural hematomas (SDHs) associated with rapidly deteriorating neurologic exam, unilaterally or bilaterally dilated nonreactive pupils, and extensor posturing are considered imminently surgical; likewise, SDHs more than 10 mm in size or those associated with more than 5-mm midline shift are deemed operative.Recent findingsWhile twist drill craniostomy and placement of subdural evacuating vport system (SEPS) are quick, bedside procedures completed under local a...
Source: Current Treatment Options in Neurology - July 18, 2018 Category: Neurology Source Type: research

What Have We Learned from Recent Clinical Studies in Low-Grade Gliomas?
This article reviews the current understanding of management of grade II gliomas in light of the recent clinical and translational studies.Recent findingsThe role of an extensive surgery at onset is now fully recognized. Recent clinical trials in the USA and Europe have demonstrated the importance of chemotherapy either in association with radiotherapy or as initial treatment to delay the risk of cognitive defects following radiation. Molecular factors, such as IDH1 or 2 mutations and 1p/19q codeletion, are favorable prognostic factors, and seem to predict a better response to chemotherapy as well.SummaryThe role of conven...
Source: Current Treatment Options in Neurology - July 4, 2018 Category: Neurology Source Type: research

Antiplatelet Agents in Secondary Stroke Prevention: Selection, Timing, and Dose
AbstractPurpose of reviewThis narrative review critically evaluated the published studies regarding the systematic use of antiplatelet agents for secondary stroke prevention.Recent findingsStroke is a leading cause of morbidity and mortality around the world. Multimodal prevention is the most viable strategy for reducing the societal burden of stroke recurrence. For secondary stroke prevention, antiplatelet therapy is at the core of effective long-term vascular risk reduction among survivors of an ischemic stroke or transient ischemic attack (TIA). In addition to aspirin, there are several antiplatelet agents proven to be ...
Source: Current Treatment Options in Neurology - June 23, 2018 Category: Neurology Source Type: research

Treatment of Visual Disorders in Parkinson Disease
This article discusses visual disorders in both Parkinson disease (PD) and other Parkinsonian disorders. It is organized largely by the anatomical site of pathology and emphasizes practical treatments. Targeted treatment options include medications, surgery, occupational, and physical therapies as well as optical aids.Recent findingsThe causes of visual complaints in Parkinson disease and other similar disorders are being more clearly identified. A new medication approved specifically to treat hallucinations in PD now is available. There is increased understanding of the important role that an ophthalmologist can play in t...
Source: Current Treatment Options in Neurology - June 23, 2018 Category: Neurology Source Type: research

Current and Emerging Therapies for Duchenne Muscular Dystrophy
AbstractPurpose of reviewThe purpose of this review is to summarize the current and emerging therapies for Duchenne muscular dystrophy (DMD).Recent findingsCoinciding with new standardized care guidelines, there are a growing number of therapeutic options to treat males with DMD. Treatment of the underlying pathobiology, such as micro-dystrophin gene replacement, exon skipping, stop codon read-through agents, and utrophin modulators showed variable success in animal and human studies. Symptomatic therapies to target muscle ischemia, enhance muscle regeneration, prevent muscle fibrosis, inhibit myostatin, and reduce inflamm...
Source: Current Treatment Options in Neurology - June 23, 2018 Category: Neurology Source Type: research